The Spectrum of Psychotic Disorders

The spectrum of psychotic disorders encompasses as many as 25 different etiologies, ranging from the primary psychoses through those secondary to medical conditions, drugs and medications, and sensory impairments. This book provides a one-stop, comprehensive review of these disorders, and gives quick comparisons for diagnostic decision-making to help with difficult differential diagnoses. Every chapter is uniformly structured to show comparisons between each disorder of presentation, course, and underlying neuropathology. Evidence for each etiology is also rated, indicating the confidence level the reader can place in the current findings. The international team of authors also examines data supporting a unitary neurobiological model of psychosis and the hypothesis that psychosis is a neurobiological syndrome similar to aphasia or apraxia.

This book represents a paradigm shift in understanding, classifying, and diagnosing these disorders, providing directions for future research and treatment. It will be of great interest to psychiatrists and neuroscientists alike.

Daryl Fujii is a Clinical Neuropsychologist based at the Hawaii State Hospital.

Iqbal Ahmed is Professor of Psychiatry at the John A. Burns School of Medicine at the University of Hawaii.

The Spectrum of Psychotic Disorders

Neurobiology, Etiology, and Pathogenesis

Edited by

Daryl Fujii and Iqbal Ahmed

CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo

Cambridge University Press
The Edinburgh Building, Cambridge CB2 2RU, UK

Published in the United States of America by Cambridge University Press, New York

www.cambridge.org
Information on this title: http://www.cambridge.org/9780521850568

© Cambridge University Press 2007

This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.

First published 2007

Printed in the United Kingdom at the University Press, Cambridge

A catalog record for this publication is available from the British Library

Library of Congress Cataloging in Publication data

The Spectrum of psychotic disorders : neurobiology, etiology, and pathogenesis / [edited by] Daryl Fujii and Iqbal Ahmed.
  p. ; cm.
 Includes bibliographical references and index.
 ISBN-13: 978-0-521-85056-8 (hardback)
 ISBN-10: 0-521-85056-8 (hardback)
 1. Psychoses–Etiology. 2. Psychoses–Physiological aspects. 3. Nervous system–Diseases–
Complications. 4. Neurobiology. I. Fujii, Daryl, 1961- II. Ahmed, Iqbal, 1951-
 [DNLM: 1. Psychotic Disorders–etiology. 2. Psychotic Disorders–physiopathology. 3. Nervous
System Diseases–complications. 4. Neurobiology–methods. 5. Schizophrenia–etiology.
6. Schizophrenia–physiopathology. WM 200 S7415 2007] I. Title.
RC512.S63 2007
616.89–dc22
                   2006032007

ISBN-13 978-0-521-85056-8 hardback
ISBN-10 0-521-85056-8 hardback

Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this publication to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacture of any drugs or equipment that they plan to use.

Contents

List of Contributors

Daniel J. Abrams
University of Colorado School of Medicine

Iqbal Ahmed
University of Hawaii

Daniel N. Allen
University of Nevada, Las Vegas

David B. Arciniegas
University of Colorado School of Medicine

Nikki Panasci Armstrong
University of Hawaii

Nick Bouras
Kings College London, United Kingdom

James A. Bourgeois
University of California, Davis Medical Center

Philip R. Burke
University of Massachusetts Medical School

Dirk M. Dhossche
University of Mississippi Medical Center

Tamara Dolenc
Mayo Clinic

James E. Emanuel
University of Pittsburgh Medical Center

Sasha Ericksen
University of Washington School of Medicine

Susan E. Fratoni
University of Massachusetts Medical School

Wanda Fremont
State University of New York, Syracuse

Daryl Fujii
Hawaii State Hospital

Gerald Goldstein
VA Pittsburgh Healthcare System Pittsburgh, PA

Jessica E. Grogan
University of Houston

Gretchen L. Haas
University of Pittsburgh

William Haning III
University of Hawaii

Colin P. Hemmings
South London and Maudsley NHS Trust, United Kingdom

Suzanne Holroyd
University of Virginia

Robin A. Hurley
VISN 6 MIRECC, Hefner VAMC, WFUSM, BCM Salisbury, North Carolina

Elizabeth Jacobs
University of Hawaii

Angelina Kakooza-Mwesige
Makerere University Medical School

John Kasckow
University of Cincinnati

Wendy R. Kates
State University of New York, Syracuse

John T. Little
Johns Hopkins University School of Medicine

Theo Manschreck
Harvard University

Andreas Marneros
Martin-Luther-Universität Halle-Wittenberg, Germany

Somaia Mohamed
Cincinnati VA Medical Center

Stephen E. Nicolson
Massachusettes General Hospital

Luis Alfonso Núñez Domínguez
Centro Médico, Navarra, Spain

Katerine Osatuke
VHA National Center for Organization Development

Frank Pillmann
Martin-Luther-Universität Halle-Wittenberg, Germany

Sarah Reading
Johns Hopkins University School of Medicine

Anthony J. Rothschild
University of Massachusetts Medical School and UMass Memorial Healthcare, Inc.

Teresa Rummans
Mayo Clinic

Perminder Sachdev
University of New South Wales, Australia

Erin Y. Sakai
Beth Israel Deaconess Medical Center

Jason Schiffman
University of Hawaii

Eric G. Smith
University of Massachusetts Medical School and UMass Memorial Healthcare, Inc.

Laura Stoppelbein
University of Mississippi Medical Center

David L. Sultzer
University of California at Los Angeles and VA Greater Los Angeles Healthcare System

Robert A. Sweet
University of Pittsburgh Medical Center

Katherine H. Taber
VISN 6 MIRECC, Hefner VAMC, WFUSM, BCM Salisbury, North Carolina

Junji Takeshita
University of Hawaii

Diane Thompson
Queen’s Medical Center

Debby Tsuang
University of Washington School of Medicine

George Webster Ross
VA Pacific Islands Healthcare System

Chelsea S. Wogsland
University of Massachusetts Medical School

Deborah Yurgelun-Todd
Harvard Medical School and McLean Hospital

Preface

Psychotic disorders of different etiologies have interested both clinicians and researchers, but for different reasons. People with psychosis have been some of the most challenging for clinicians to treat due to the severity and chronicity of symptoms. One potential problematic aspect of treatment is differential diagnosis as psychosis can result from numerous etiologies and many patients have more than one risk factor. A review of the presentation, course and progression, and optimal treatment strategies would certainly be useful for clinicians in making these determinations.

For researchers and theoreticians, secondary or “organic” psychotic disorders can provide clues to underlying neurobiological mechanisms of schizophrenia or psychosis in general. Unfortunately, thus far, this potential avenue of research has not been adequately explored. One problem is that the literature on the “so called” secondary psychotic disorders is not readily available for study or review. There are many different etiologies, thus amassing this disparate literature would take a concerted effort. In addition, much of the information on “organic psychosis,” particularly for the obscure etiologies, is provided in case studies or case series, many in difficult-to-find journals. We believe these problems in access to information have prevented researchers from mining this rich resource.

The purpose of this book is to address the needs of both clinician and researcher by providing comprehensive reviews of psychotic disorders of different etiologies in one handy resource. For clinicians faced with difficult and fascinating differential diagnoses, this compendium allows quick comparisons useful for diagnostic decision-making. For researchers and theoreticians interested in the neurobiology of schizophrenia and psychosis, we compare and contrast the current data in searching for clues on the neurobiological essence of psychosis. Specifically, we examine the hypothesis that psychosis is a neurobiological syndrome similar to aphasia or apraxia.

There are two unique organizational features of our book. First, each chapter is uniformly structured to aid in comparison of the presentation, course, and underlying neuropathology between each disorder. Second, authors have rated the level of evidence for each etiology indicating the confidence level the reader can place in the current findings.

 We hope you find this book useful in your practice and research.

Acknowledgements

There are many people we would like to acknowledge in the making of this book. First, we would like to thank all the contributing authors for their efforts, expertise, and taking time out of their busy schedules to collaborate with us.

Second, we would like to thank the researchers who have trodden the path of organic psychosis and inspired us to continue the exploration. These people include: Kenneth Davison and Christopher Bagley, pioneers in compiling information on secondary psychotic disorders; Alwyn Lishman for piquing everyone's interest in organic psychiatry; and Jeffrey Cummings for his seminal ideas in the neuropsychiatry of psychosis. With this book, we hope to carry the torch in this area of study.

Third, we would like to thank the individuals who have facilitated our research over the years: librarian Lisa Anne Matsumoto who special ordered many of our journal articles; and administrative assistant Sharon Lai for her multiple contributions. We would also like to thank Erin Sakai and Cale Palmer for their assistance in compiling and rating the data in the chapters.

Last, but not least, we would like to thank our families, without whose love, support, and patience our work could not have been accomplished.

Daryl would like to thank his beautiful wife Sam, two eggies Dylan and Cody, loving parents Earl and Judy Fujii, big brother Jay and his family, Naomi and Jarin, grandparents Kenneth Ito and the late Mildred Ito and Shizuko Fujii.

Ike would like to thank numerous colleagues, and students who have helped shape his ideas over the years, his co-author Daryl for his years of collaboration and for the active exchange of ideas which led to the writing of the book, and for being the force behind getting these ideas out into the public domain. Finally, he would like to thank his lovely wife Lisa, for her love and enduring support, and his two daughters Yasmin and Jihan for their love and the joy they have provided.